| NPI | 1205840519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY JACOBSON VP 386-326-1225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: FL 54QP00053) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2013-07-16 |